| Theme |
Therapeutic Strategy for Early Gastrointestinal Cancers with EMR or ESD |
| Title |
Endoscopic Strategy for Early Gastric Cancer |
| Author |
Mikitaka Iguchi |
2nd Department of Internal Medicine, Wakayama Medical University |
| Author |
Hisanobu Deguchi |
2nd Department of Internal Medicine, Wakayama Medical University |
| Author |
Kimihiko Yanaoka |
2nd Department of Internal Medicine, Wakayama Medical University |
| Author |
Kenji Arii |
2nd Department of Internal Medicine, Wakayama Medical University |
| Author |
Masashi Oka |
2nd Department of Internal Medicine, Wakayama Medical University |
| Author |
Masao Ichinose |
2nd Department of Internal Medicine, Wakayama Medical University |
| [ Summary ] |
Endoscopic mucosal resection (EMR)is a minimally invasive treatment for early gastric cancer. Recently, endoscopic techniques have been rapidly improved. Endoscopic submucosal dissection (ESD) is a new endoscopic surgery technique for en bloc resection of early neoplastic lesions in the gastrointestinal tract. Using this method, histological examinations can be performed more precisely, resulting in decreased local recurrence.
In our hospital, ESD has been performed for 250 cases of early gastric neoplasitc lesions. Histologically, curative resection was seen in 226 cases (91 %). Recurrence or metastasis was not seen in these cases. Local recurrence was seen in 2 cases. In both cases, the lateral margin was positive because of misdiagnosis of lateral extension. Major complications such as delayed bleeding and perforations was occurred in 2 cases (0.8 %) and 9 cases (3.6 %) respectively. All cases were endoscopically controlled without emergency surgery. It should be noted that not only are high quality incision techniques necessary but also diagnostic ability and post operative managiment for the performance of successful ESD. |